No, Callous Americans, Private Giving Can't Replace Obamacare

Christopher Flavelle writes editorials on health care, energy and environment for Bloomberg View. He was a senior policy analyst for Bloomberg Government and chief speechwriter for the leader of the Liberal Party of Canada.Read More.

Yesterday I wrote that public support for helping the needy, whether through health coverage, food and housing or other benefits, has fallen since the start of the recession. Many readers responded that Americans don't oppose all aid -- just aid delivered by the government. Personal giving, these readers argued, is a reasonable substitute for programs such as Obamacare, food stamps or welfare.

The problem is the numbers don't bear that out. To be sure, almost 90 percent of Americans give to charity, and they gave a total of $316 billion last year. That's a staggering amount, and Americans should certainly be proud of it. At the same time, that money can't replace the government-run programs that have engendered so much public opposition, for a number of reasons.

One reason is the cycle of giving. Donations rise during good times and fall during bad; the $316 billion given last year is high, but it's still less than any of the three years leading up to the last recession. It's understandable that people would have less to give when times are hard, but happens to be the exact time when the need is highest.

Another reason private giving isn't a substitute for government aid is where that money goes: Just 12 percent of all giving in 2011 went to human services, behind religious organizations (32 percent) and education (13 percent). Some of the money you give to your church or synagogue will go to helping the needy, but not all of it. And donations to your alma mater, your children's school or your favorite art gallery are crucial for society, but they don't feed the poor or pay for doctor visits.

A third reason is scale. The food stamps program cost $78 billion last year, and Medicaid cost $251 billion. Temporary Assistance for Needy Families, or what used to be called welfare, cost another $31 billion. Once the Obamacare exchanges reach something like full capacity in 2017, federal subsidies for insurance on those exchanges is projected to cost about $108 billion. And that's before we even mention Social Security, which cost $773 billion in 2012.

So the idea that a reduction in these programs could somehow be made up for by an increase in private giving just doesn't reflect reality. In a country where 57 million people don't have health insurance and one in four children live in poverty, falling support for government welfare programs can't be defended on the grounds that Americans remain individually charitable.

This column does not necessarily reflect the opinion of Bloomberg View's editorial board or Bloomberg LP, its owners and investors.

Christopher Flavelle writes editorials on health care, energy and environment for Bloomberg View. He was a senior policy analyst for Bloomberg Government and chief speechwriter for the leader of the Liberal Party of Canada.Read more